ArticleCMAJ open
Trends in prostate cancer incidence and mortality in Canada during the era of prostate-specific antigen screening.
Article in CMAJ open. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.
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Who cites it
20 citing papers in PubMed.
- Recent incidence and surgery trends for prostate cancer: Towards an attenuation of overdiagnosis and overtreatment?PloS one · 2019Trial
- Canadian Prostate Cancer Trends in the Context of PSA Screening Guideline Changes.Current oncology (Toronto, Ont.) · 2025Article
- Prostate Cancer Mortality Trend in Montenegro 1990-2018.Iranian journal of public health · 2025Article
- The natural history of prostate cancer.Canadian Urological Association journal = Journal de l'Association des urologues du Canada · 2025Review
- Impact of the diagnostic label for a low-risk prostate lesion: protocol for two online factorial randomised experiments.BMJ open · 2024Article
- Targeting PI3K/Akt signaling in prostate cancer therapy.Journal of cell communication and signaling · 2023Review
- Low-risk prostate lesions: An evidence review to inform discussion on losing the "cancer" label.The Prostate · 2023Review
- Assessment of the epidemiological trends for prostate cancer using administrative data in Ontario.Canadian Urological Association journal = Journal de l'Association des urologues du Canada · 2023Article
- Article
- Screening for prostate cancer: protocol for updating multiple systematic reviews to inform a Canadian Task Force on Preventive Health Care guideline update.Systematic reviews · 2022Article
- Treatment and trials in non-metastatic castration-resistant prostate cancer.Nature reviews. Urology · 2021Review
- Incidence and Mortality of Prostate Cancer in Canada during 1992-2010.Current oncology (Toronto, Ont.) · 2021Article
- Personalized strategies in population screening for prostate cancer.International journal of cancer · 2020Review
- Percutaneous MR-guided whole-gland prostate cancer cryoablation: safety considerations and oncologic results in 30 consecutive patients.The British journal of radiology · 2019Article
- Expression and clinical significance of Caveolin-1 in prostate Cancer after transurethral surgery.BMC urology · 2018Article
- Prostate cancer surveillance by occupation and industry: the Canadian Census Health and Environment Cohort (CanCHEC).Cancer medicine · 2018Article
- Prevention of Prostate Tumor Development by Stimulation of Antitumor Immunity Using a Standardized Herbal Extract (Deep Immune®) in TRAMP Mice.Evidence-based complementary and alternative medicine : eCAM · 2018Article
- Mortality Rate and Years of Life Lost Due to Prostate Cancer in Yazd Province, Iran: A 10-year study.Sultan Qaboos University medical journal · 2017Article
- Can you un-ring the bell? A qualitative study of how affect influences cancer screening decisions.BMC cancer · 2017Article
- Cancer and the healthy immigrant effect: a statistical analysis of cancer diagnosis using a linked Census-cancer registry administrative database.BMC public health · 2017Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWidespread use of prostate-specific antigen (PSA) to screen for prostate cancer began in the early 1990s. Advocates for screening assert that this has caused a decrease in prostate cancer mortality. We sought to describe secular changes in prostate cancer incidence and mortality in Canada in relation to the onset of PSA screening.
methodsAge-standardized and age-specific prostate cancer incidence (1969-2007) and mortality (1969-2009) from Public Health Agency of Canada databases were analyzed by joinpoint regression. Changes in incidence and mortality were related to introduction of PSA screening.
resultsPrior to PSA screening, prostate cancer incidence increased from 54.2 to 99.8 per 100 000 between 1969 and 1990. Thereafter, incidence increased sharply (12.8% per year) to peak at 140.8/100 000 in 1993. After decreasing in all age groups between 1993 and 1996, incidence continued to increase for men aged less than 70 years, but decreased for older men. Age-standardized mortality was stable from 1969 to 1977, increased 1.4% per year to peak in 1995 and subsequently decreased at 3.3% per year; the decline started from 1987 in younger men (age < 60 yr).
interpretationIncidence was increasing before PSA screening occurred, but rose further after it was introduced. Reductions in prostate cancer mortality began before PSA screening was widely used and were larger than could be anticipated from screening alone. These findings suggest that screening caused artifactual increase in incidence, but no more than a part of reductions in prostate cancer mortality. The reduction may be due to changing treatment or certification of death.
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